The diagnosis, pathology and treatment of diseases of women : including the diagnosis of pregnancy / by Graily Hewitt.

  • Hewitt, Graily, 1828-1893.
Date:
1868
Catalogue details

Licence: Public Domain Mark

Credit: The diagnosis, pathology and treatment of diseases of women : including the diagnosis of pregnancy / by Graily Hewitt. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    complete]y disappear. The presence of chorion villi may be con- sidered quite conclusive as to the fact of impregnation and pre- vious conception, whether the embryo be found or not; but it is a question whether the same degree of diagnostic value attaches to the presence of the decidua materna, it being the fact that a mem- brane may be expelled from the uterus quite independently of con- ception, and possessing many of the characters of the decidua as above described. In the decidua resulting from pregnancy, the decidual cotyledons are present; but not in the other. This is the best distinction which can at present be given ; but, from exami- nation of certain specimens, 1 have come to the conclusion that cases might arise in which this means of distinguishing them might fail. If a small sac were found having attached at a point of its in- ternal surface the remains of the umbilical cord, this would be con- clusive on the question of impregnation. In the case of early ova expelled from the uterus, one of several results may be observed. The ovum enveloped in the decidua may come away entire; the decidua may remain behind for a time ; and the chorion membrane covered by its villi, and inclosing the embryo, be expelled by itself. The chorion and amnion may remain in utero as well as the decidua, the embryo escaping from the uterus. In such a case, the membranes, foetal and maternal, would be expelled sub- sequently. Moles.—The various substances known under the designation of moles, and which are the products of conception,* are for the most part the result of arrest of development, which may coexist with continuance of growth of some portion of the ovum. It is very important to be aware of the fact, that an ovum, or some part of it, may remain in the uterus for a very considerable time, grow- ing in an irregular abnormal manner, or just preserving a low form of vitality. A practical instance will show the importance of this knowledge. A woman having lost her husband five or six months may have an attack resembling an abortion, and there may be expelled a substance which the observer believes to be an ovum of two months, whereas it turns out, on examination by a more competent hand, to be a mole, the product of a conception previous to the husband's death. The fleshy mole, as it is termed, consists of an ovum between the membranes of which * It seems proper to confine tTie use of the term mole to the products of conception alone.